A 62-year-old woman undergoing chemotherapy for breast cancer presents with acute dyspnea and pleuritic chest pain. Vital signs show BP 138/82, HR 102, RR 22, temp 37.8°C, SpO2 88%. Serum triglycerides are 2800 mg/dL with amylase 450 U/L. Chest imaging reveals bilateral pulmonary infiltrates. She denies recent alcohol use. Which mechanism best explains the markedly elevated triglycerides in this chemotherapy-induced acute pancreatitis?
- A)Reduced hepatic VLDL clearance due to decreased lipoprotein lipase activity from pancreatic inflammationGABARITO
- B)Acute onset hepatic steatosis reducing apoB-100 synthesis
- C)Chemotherapy-induced inhibition of HMG-CoA reductase reducing lipolysis
- D)Acute hyperglycemia stimulating VLDL particle number synthesis
- E)Increased intestinal absorption of dietary fat leading to chylomicronemia
Explicação
In acute pancreatitis, the inflamed pancreas produces less lipoprotein lipase (the enzyme responsible for hydrolyzing triglycerides from circulating lipoproteins in the capillary endothelium). This reduced lipolytic activity causes severe hypertriglyceridemia ... Ver explicação completa e trilha adaptativa →